Table 3–
Characteristics of subjects that were noted to follow commands during subsequent encounters and did not follow commands at hospital discharge.
| Subject | Clinical scenario | Arrest details | Arrest etiology | CTH GWR | SSEP | MRI radiologist interpretation | Discharge disposition and exam | Time to commands |
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| 1 | 26-year-old man with history of opioid use disorder found in bed unresponsive. | No bystander CPR, PEA initial rhythm, 14 minutes CPR, 5 mg epinephrine and 1 shock. | Toxicological | NA | NA | Diffusion restriction of cortical white matter of all lobes as well as dentate nuclei and the lentiform nuclei. Unclear if result of heroin inhalation vs. anoxic changes. | Long term acute care. No response to painful stimuli | 155 days |
| 2 | 55-year-old woman with history of hypothyroidism complained of shortness of breath, then collapsed in front of family. | Witnessed collapse, bystander CPR, asystolic initial rhythm, 37 minutes CPR, 7 mg epinephrine, 8 shocks. | Structural heart disease | NA | Present N20 response | Diffusely abnormal gyral edema and restricted diffusion compatible with severe hypoxic ischemic injury, also involving the caudate nuclei. | Long term acute care. Tracked examiner but fid not follow commands. | 3 yrs & 2 months Noted following commands at well patient visit. Discharge from long term acute care to brain injury rehab is not in health system. |
| 3 | 65-year-old man with history of schizophrenia and atrial fibrillation had a witnessed shaking episode and became unresponsive in front of family. | Witnessed collapse, bystander CPR, aystolic initial rhythm, 16 minutes CPR, 3 mg epinephrine, 3 shocks. | Unknown, inconclusive workup but presumed seizure with unclear cause | 1.36 | NA | No territorial infarct or evidence of diffuse anoxic brain injury. | Long term acute care. Startles but does not track or follow commands | 21 days |
| 4 | 67-year-old woman with history of hypertension pulled off road while driving and collapsed in view of bystanders. | Witnessed collapse, bystander CPR, VT/VF initial rhythm, 28 minutes CPR, 3 mg epinephrine, 6 shocks. | Acute coronary syndrome | 1.44 | Present N20 response | Cortical edema and gyriform restricted diffusion in the bilateral parietal, medial frontal, and posterior temporal lobes consistent with hypoxic ischemic injury. | Long term acute care. Tracked examiner but did not follow commands. | 39 days |
| 5 | 19-year-old man with no medical history fell and was pinned by bulldozer, with concomitant TBI and polytrauma. | Witnessed trauma, bystander CPR, VT/VF initial rhythm, 5 minutes CPR, 0 mg epinephrine, 1 shock. | Tension pneumothorax | 1.29 | Absent N20 response | Bilateral decompressive craniectomies with unchanged herniation of the brain through the surgical defects. Findings consistent with diffuse axonal injury corresponding to grade II given the involvement of the corpus callosum. | Acute rehabilitation. Startles but does not track or follow commands | 198 days |